Active NPI
Ondrej Chudoba, M.D., S.C.
- Psychiatry Physician
- Huntley, IL
National Provider Identifier
1154498533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- ONDREJ CHUDOBA, M.D., S.C.
- Practice address
- 11317 Smith Dr
11924 Oak Creek Parkway
Huntley, IL 60142-9602 - Phone
- (847) 515-8131
- Fax
- (847) 515-8142
- NPI assigned
- Nov 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ondrej Chudoba, M.D.
- Title
- President
- Phone
- (630) 415-3087
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | IL | Primary |
Addresses
Primary practice location
11317 Smith Dr
11924 Oak Creek Parkway
Huntley, IL 60142-9602
Mailing address
11317 Smith Dr
11924 Oak Creek Parkway
Huntley, IL 60142-9602
Phone (847) 515-8131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1627496 | Other | IL | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
1541 Clinton Pl
River Forest, IL 60305
Phone (630) 415-3087
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1154498533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11317 SMITH DR",
"address_2": "11924 OAK CREEK PARKWAY",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "601429602",
"telephone_number": "847-515-8131",
"fax_number": "847-515-8142"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11317 SMITH DR",
"address_2": "11924 OAK CREEK PARKWAY",
"city": "HUNTLEY",
"state": "IL",
"postal_code": "601429602",
"telephone_number": "847-515-8131",
"fax_number": "847-515-8142"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ONDREJ CHUDOBA, M.D., S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-11-29",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "CHUDOBA",
"authorized_official_first_name": "ONDREJ",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "630-415-3087",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "1627496",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Huntley, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.